Assurance de qualité pour le cancer rectal – phase 2 ...
Assurance de qualité pour le cancer rectal – phase 2 ...
Assurance de qualité pour le cancer rectal – phase 2 ...
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KCE Reports 81 PROCARE <strong>–</strong> <strong>phase</strong> 2 1Tab<strong>le</strong> of contentsScientific summary1 INTRODUCTION............................................................................................................ 42 DEVELOPMENT OF A QUALITY INDICATOR SET................................................. 72.1 METHODOLOGY........................................................................................................................................ 72.1.1 Literature search .............................................................................................................................. 72.1.2 Definition of quality <strong>le</strong>vels .............................................................................................................. 72.1.3 Se<strong>le</strong>ction process of quality indicators ........................................................................................ 72.2 RESULTS......................................................................................................................................................... 82.2.1 Search for and se<strong>le</strong>ction of quality indicators ............................................................................ 82.2.2 Overview of se<strong>le</strong>cted quality indicators ...................................................................................... 92.3 DISCUSSION...............................................................................................................................................133 FEASIBILITY STUDY OF QUALITY INDICATOR MEASUREMENT ................... 143.1 METHODOLOGY......................................................................................................................................143.1.1 Definition of se<strong>le</strong>cted quality indicators....................................................................................143.1.2 Source databases............................................................................................................................143.1.3 Translation of se<strong>le</strong>cted quality indicators into measurab<strong>le</strong> co<strong>de</strong>s .......................................163.1.4 Per-centre-analysis.........................................................................................................................173.1.5 Statistics............................................................................................................................................173.1.6 Aggregation of the results ............................................................................................................183.2 RESULTS.......................................................................................................................................................193.2.1 Description of study cohorts.......................................................................................................193.2.2 Results of pilot testing per sub-discipline..................................................................................223.2.2.1 General quality indicators............................................................................................................................... 223.2.2.2 Quality indicators related to diagnosis and staging................................................................................. 303.2.2.3 Quality indicators related to neoadjuvant treatment.............................................................................. 383.2.2.4 Quality indicators related to surgery ........................................................................................................... 433.2.2.5 Quality indicators related to adjuvant treatment..................................................................................... 503.2.2.6 Quality indicators related to palliative treatment.................................................................................... 543.2.2.7 Quality indicators related to follow-up........................................................................................................ 563.2.2.8 Quality indicators related to histopathologic examination .................................................................... 573.2.3 Aggregation of the results at hospital <strong>le</strong>vel...............................................................................623.3 DISCUSSION...............................................................................................................................................663.3.1 Measurability of the se<strong>le</strong>cted quality indicators.......................................................................663.3.2 Definition of quality indicators ....................................................................................................663.3.3 Possib<strong>le</strong> prob<strong>le</strong>ms with the interpretation of the quality indicators...................................663.3.4 Comp<strong>le</strong>mentarity of both databases ..........................................................................................713.3.5 High versus low performance on quality indicators ...............................................................723.3.6 Generalisability of this project.....................................................................................................734 INTERNATIONAL EXPERIENCES WITH QUALITY MEASUREMENT OFRECTAL CANCER CARE............................................................................................. 744.1 INTRODUCTION......................................................................................................................................744.2 METHODOLOGY......................................................................................................................................744.3 RESULTS.......................................................................................................................................................754.3.1 Rectal <strong>cancer</strong> databases in Western Europe............................................................................754.3.2 Availability of PROCARE quality indicators in Western European databases ..................774.4 DISCUSSION...............................................................................................................................................785 CONCLUSIONS ............................................................................................................ 806 APPENDICES................................................................................................................. 82
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